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Obesity Linked to Higher Health Care Cost Hikes Than Smoking or Problem Drinking

RAND News Release
See also Surgeon General's Call to Action on overweight and obesity

 
 

 

SANTA MONICA, Calif., March 12 - Obesity contributes to higher cost increases for health care services and medications than do either smoking or problem drinking, a RAND researcher concludes in a report published in the journal Health Affairs being released today. In fact, the report finds that obesity has roughly the same association with chronic health conditions as a person who has gone from age 30 to age 50.

The study compares the effects of obesity, smoking and problem drinking on health care utilization and health status, using national survey data. Obesity is associated with a 36% increase in inpatient and outpatient expenditures and a 77% increase in medication costs than people falling within a normal weight range, while current smokers see increases of only 21% for services and 28% for medications over those of non-smokers, and problem drinkers see an even lesser effect for both. Meanwhile, aging from 30 to 50 is associated with a 20% hike in service costs, but a 105% increase in medication costs.

The study reinforces growing concerns about how dramatically increasing obesity in the U.S. will negatively affect health care costs as well as overall public health.

"Obesity appears to have a stronger association with the occurrence of chronic medical conditions, reduced physical health-related quality of life, and increased health care and medication expenditures than smoking or problem drinking. Only 20 years aging has similarly-sized effects," declared author Roland Sturm, a RAND economist.

Sturm used data from Healthcare for Communities, a national household telephone survey of about 10,000 respondents taken in 1997-98. The results are based on the subset of adults between 18 and 65 years of age. He also used the body mass index (BMI), a ratio of height to weight, to define overweight and obesity. (For example, someone who is 5 ft. 4 in. tall and weighs 174 lbs. or more is considered obese, as is a person who is 5 ft. 10 in. tall and weighs 209 lbs. or more.) According to those criteria, one in five Americans is obese, while an additional one in three is overweight. Obesity has increased by 60 percent between 1991 and 2000, while smoking rates have been cut roughly in half since 1964.

Sturm cautions that the full long-run consequences of increased obesity rates are not yet fully visible, because of the time lag between the onset of obesity and the development of chronic health problems.

"The largest declines in smoking rates happened between 1960 and 1980, whereas the largest increase in obesity has occurred since 1980," Sturm notes. He adds that there are important outcomes outside the scope of his analysis that could provide a different ranking. Smoking may still account for more premature deaths and alcohol abuse is likely to account for more externalities (e.g. drunk driving accidents).

Sturm used similar survey data in a study he co-authored last year that found more Americans are overweight or obese than, collectively, are daily smokers, problem drinkers, and below the federal poverty line.

Both studies were funded by the Robert Wood Johnson Foundation. RAND is a nonprofit organization that helps improve policy and decisionmaking through research and analysis. ##

 

RAND News Release
Public Information Office, 310-451-6913
Not for release until 12:01 a.m. Tuesday, March 12, 2002

Sturm R. The Effects of Obesity, Smoking, and Problem Drinking on Chronic Medical Problems and Health Care Costs. Health Affairs. 2002;21(2):245-253.

Sturm R, Wells KB. Does Obesity Contribute As Much to Morbidity As Poverty or Smoking? Public Health. 2001;115:229-295.

Link to Research Brief: http://www.rand.org/publications/RB/RB4549/